Provider Demographics
NPI:1104040377
Name:BALANCED BODIES CHIROPRACTIC AND KINESIOLOGY PA
Entity Type:Organization
Organization Name:BALANCED BODIES CHIROPRACTIC AND KINESIOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-977-0005
Mailing Address - Street 1:8811 WESTHEIMER RD
Mailing Address - Street 2:STE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3626
Mailing Address - Country:US
Mailing Address - Phone:713-977-0005
Mailing Address - Fax:713-977-2131
Practice Address - Street 1:8811 WESTHEIMER RD
Practice Address - Street 2:STE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3626
Practice Address - Country:US
Practice Address - Phone:713-977-0005
Practice Address - Fax:713-977-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6174111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8C6329Medicare ID - Type UnspecifiedINDIVIDUAL
TXU41884Medicare UPIN